Policy Framework for Outreach, Enrollment, Retention and Utilization for Health Care Coverage in California

Defines a framework that counties in California can use to structure outreach, enrollment, retention, and utilization systems and strategies. Provides specific recommendations, based on local successes, for improving access to health care by children

Is Virtual Reality for Acute Pain Reduction in Adolescents Undergoing Burn Wound Care Effective?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of virtual reality (VR) is an effective method of pain reduction in adolescents undergoing burn wound care. STUDY DESIGN: Includes a review of two English based randomized controlled trials, and one English based descriptive exploratory study. These studies were published in 2007-2014. DATA SOURCES: Two randomized control trials (RCT’s) and one exploratory study were found searching PubMed database. Both the random control trials and the exploratory study compare the use of virtual reality interventions against either medical management only or a combination of medical management and passive distraction techniques. OUTCOMES MEASURED: Pain intensity was measured using APPT, Speilberger state-trait anxiety inventory for children, Pre-procedural questionnaire, Post-procedural questionnaire, VAS – visual analogue scale (self-reported), VAS – visual analogue scale (caregiver reported), FLACC – Faces, legs, activity, cry, consolability – nurse observations, Adolescent reactions, and Faces scale. RESULTS: The RTC by Kipping, et al. showed no statistically significant improvement in pain intensity using virtual reality for adolescent burn care (P value=0.16 (dressing removal) and P value=0.40 (Dressing application)). The RTC by Jeffs, et al. showed no statistically significant improvement in pain intensity using virtual reality for adolescent burn care (P value=0.029). The exploratory study by Chan, et al. et al showed no statistically significant improvement in pain intensity using virtual reality for adolescent burn care (P value\u3e0.05) CONCLUSIONS: There was no clinically significant decrease in self-reported pain intensity with the use of VR during wound care in both the RTC by Kipping, et al. and RTC by Jeffs, et al. respectively. In the exploratory study by Chan, et al.; although not clinically significant, the VR intervention is more effective than simple distraction for pain reduction

The Journals of Martha E. McMillan

This document is a compilation of the transcriptions and research done by the instructor and students of the American Women Writer\u27s course at Cedarville University during spring semester 2015.https://digitalcommons.cedarville.edu/mcmillan_supplemental_material/1002/thumbnail.jp

Eleven case studies of parents\u27 experiences when accessing services for an Autistic Spectrum Disorder child

The purpose of this study is to understand parent\u27s experiences of accessing services for their ASD children. It was the researcher\u27s goal to document parent\u27s stories and experiences of accesssing services for their ASD children. This research project engaged 11 families in in-depth interviews exploring their experiences accessing services. Four areas of services emerged from the interviews: diagnostic services, services through Regional Centers, services offered at their child\u27s school, and other services accessed (i.e. through insurance or community organizations)

Nutritional Assessment of Rural Mossi People in Burkina Faso: A Comparison of Pre- and Post-Harvest Status

The purpose of this study was to compare the nutritional status of a rural population of Mossi people in Burkina Faso during the pre- and post-harvest seasons. Comparisons were made between the sample population and the American population, between the pre- and post-harvest seasons, between males and females in the sample population and between the various age groups in the sample population. This nutritional assessment consisted of collecting demographical information, anthropometrical measurements such as weight and height, a clinical assessment to evaluate physiological signs of nutritional deficiencies and a food frequency questionnaire to describe the dietary practices of the population. Due to the potential risks of handling human blood, urine and feces, biochemical analyses were not performed in this study. Special attention was given to the nutritional problems most common in Africa: protein energy malnutrition, vitamin A deficiency, iron deficiency and goiter. Adults in this study had an average body mass index of 19.1, classifying the adult population as underweight . The population of American adults, however, has a tendency toward a body mass index in the slightly overweight category. The BMI range of adults in the study population was 12.9 to 27.8. A total of 36.9% of the adult population presented with some level of protein energy malnutrition while only 2.7% were slightly obese. Seventy percent of children were below the 50th percentile on the 2000 Centers for Disease Control weight-for-height growth chart. A third of all children were below the 3rd percentile of weight-for-height. The vast majority of children in this study had a weight-for-height below the median, or average , American child. The mean percent of median body weight-for-height for the child population in the lean season was 85.2% indicating that the median child in this sample population was mildly wasted. The mean percent of median weight-for-height rose to 94.6% in the post-harvest season indicating that the median child of the sample population was normal concerning wasting status. The results of this study indicate that this rural population of Mossi people was less well-nourished than their American counterpart and that their nutritional status differed based on season (F=[4,177] 4.77, p=.03 for adults and F=[4,51] 8.56, p=.005 for children) but not gender (F=[ 4,177] .04, p=.83 for adults and chi square= 4.37, p=.22, df=3 for children) or age group for adults (r=.l 0, p=.29). In children, nutritional status was based on age group (but contrary to the expected outcome) with prepubescent children having lower weight-for-height percentiles than the under-five population (chi square = 40.34, p=.02, df=24). Nutritional status improved as predicted during the postharvest, or plentiful, season. Due to the lack of biochemical analyses, the potential vitamin and mineral deficiencies indicated in the brief physical examination were not confirmed. Vitamin A deficiency was the most likely nutrient deficiency; symptoms occurred in 51% of the population, primarily in adults and older children. PEM, although indicated by the anthropometric measures to affect 37.1% of the adult population and 55.4% of the child population, did not greatly manifest itself in clinical symptoms. The incidence of iron deficiency anemia was also relatively low with only 7% of the population presenting with pale conjunctivae, a potential, but non-specific sign of iron deficiency anemia. The goiter rate was also very low with only two cases occurring during the post-harvest season

Functional study of a novel missense single-nucleotide variant of NUP107 in two daughters of Mexican origin with premature ovarian insufficiency.

BackgroundHypergonadotropic hypogonadism (HH) is a genetically heterogeneous disorder that usually presents with amenorrhea, atrophic ovaries, and low estrogen. Most cases of HH are idiopathic and nonsyndromic. Nucleoporin 107 (NUP107), a protein involved in transport between cytoplasm and nucleus with putative roles in meiosis/mitosis progression, was recently implicated as a cause of HH. We identified a NUP107 genetic variant in a nonconsanguineous family with two sisters affected with primary amenorrhea and HH, and generated a mouse model that carried the human variant.MethodsWe performed a high-resolution X-chromosome microarray and whole exome sequencing on parents and two sisters with HH to identify pathogenic variants. We generated a mouse model of candidate NUP107 variant using CRISPR/Cas9.ResultsWhole exome sequencing identified a novel and rare missense variant in the NUP107 gene (c.1063C>T, p.R355C) in both sisters with HH. In order to determine functional significance of this variant, we used CRISPR/Cas9 to introduce the human variant into the mouse genome. Mice with the homolog of the R355C variant, as well as the nine base pairs deletion in Nup107 had female subfertility.ConclusionsOur findings indicate that NUP107 R355C variant falls in the category of variant of unknown significance as the cause of HH and infertility

LC-MS/MS reveals hordeins are enriched in brewers’ spent grain

Barley is commonly used in malting and brewing, and spent grain is repurposed for other foods. Barley contains gluten proteins called hordeins that cause intestinal damage and disease symptoms if eaten by people with celiac disease and related conditions. While the mashing process in brewing can partially hydrolyze immunogenic epitopes in hordeins, the immunogenic epitope load between the starting malt and spent grain has not been investigated. Herein, we quantified hordeins in commercially available spent grain and from matching malt. Liquid chromatography-mass spectrometry (LC-MS) and sandwich and competitive R5 ELISAs were used for quantification, revealing a higher abundance of gluten proteins in the spent grain product compared with the input malt. Certain hordein subtypes were enriched while others were depleted, and overall protein content was higher in spent grain. This suggests that the mashing process selectively extracts nonprotein components, leaving protein and hordein content elevated in spent grain. The spent grain products tested were not safe for consumers with celiac disease